=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508807801
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NET 30, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2006
-----------------------------------------------------
Last Update Date | 02/19/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 75 MAIDEN LN 7TH FLOOR ATT: KELVIN NG
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10038-4819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-228-1994
-----------------------------------------------------
Fax | 212-405-2390
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 75 MAIDEN LN 7TH FLOOR ATT: KELVIN NG
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10038-4819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-228-1994
-----------------------------------------------------
Fax | 212-405-2390
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. CAROLINE M. BARRETT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 212-228-1994
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HHA 299991426
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------